Cerebral hemispherectomy

Jonas, Rinat; Nguyen, Snow; Hu, Bin; Asarnow, Robert F.; LoPresti, Christine; Curtiss, Susan; Bode, Stella de; Yudovin, Sue; Shields, W. Donald; Vinters, Harry V.; Mathern, Gary W.

doi:10.1212/01.wnl.0000127109.14569.c3

Cited by 288 publications

(277 citation statements)

References 44 publications

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“…Clinically, HME is associated with developmental delay and severe epilepsy with onset typically within the first few months of life [227][228][229][230][231]. Epilepsy is often resistant to pharmacological treatment, requiring surgical intervention to remove or functionally disconnect the epileptogenic area within the affected hemisphere [232]. HME can occur as an isolated malformation or associated with several syndromes [230,231,233,234].…”

Section: Clinical and Neuropathological Featuresmentioning

confidence: 99%

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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Section: Clinical and Neuropathological Featuresmentioning

confidence: 99%

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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“…The onset of seizures disrupted this development and very quickly became refractory to medications. The kinds of seizures varied greatly, with daily occurrences of up to 250 episodes [32]. The cerebral hemispherectomy procedure was anatomical in participants 2F and 7M and functional, with complete disconnection, in the rest of the group [33].…”

Section: Recruitment and Clinical Variablesmentioning

confidence: 99%

Literacy after cerebral hemispherectomy: Can the isolated right hemisphere read?

Bode¹,

Chanturidze

Mathern

et al. 2015

Epilepsy & Behavior

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Objectives: Cerebral hemispherectomy, a surgical procedure undergone to control intractable seizures, is becoming a standard procedure with more cases identified and treated early in life [33]. While the effect of the dominant hemisphere resection on spoken language has been extensively researched, little is known about reading abilities in individuals after left-sided resection. Left-lateralized phonological abilities are the key components of reading, i.e., grapheme-phoneme conversion skills [1]. These skills are critical for the acquisition of wordspecific orthographic knowledge and have been shown to predict reading levels in average readers as well as in readers with mild cognitive disability [26]. Furthermore, impaired phonological processing has been implicated as the cognitive basis in struggling readers. Here, we explored the reading skills in participants who have undergone left cerebral hemispherectomy. Methods: Seven individuals who have undergone left cerebral hemispherectomy to control intractable seizures associated with perinatal infarct have been recruited for this study. We examined if components of phonological processing that are shown to reliably separate average readers from struggling readers, i.e., phonological awareness, verbal memory, speed of retrieval, and size of vocabulary, show the same relationship to reading levels when they are mediated by the right hemisphere [2]. Results: We found that about 60% of our group developed both word reading and paragraph reading in the average range. Phonological processing measured by both phonological awareness and nonword reading was unexpectedly spared in the majority of participants. Phonological awareness levels strongly correlated with word reading. Verbal memory, a component of phonological processing skills, together with receptive vocabulary size, positively correlated with reading levels similar to those reported in average readers. Receptive vocabulary, a bilateral function, was preserved to a certain degree similar to that of strongly left-lateralized phonological skills [3]. Later seizure onset was associated with better reading levels. Conclusions: When cerebral hemispherectomy is performed to control seizures associated with very early (in utero) insult, it has been found that the remaining right hemisphere is still able to support reading and phonological processing skills that are normally mediated by the left hemisphere. Our results also suggest the existence of variability in individuals after hemispherectomy, even within groups having the same etiology and similar timing of insult.Published by Elsevier Inc.

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“…An early surgery will acutely worsen the neurological status, but might preserve some cognitive functions; while waiting until hemiplegia occurs will reduce the risk of creating new deficits through surgery, but to delay the surgery might have a negative effect on cognitive outcome. 34,51 Timing of surgery becomes an important issue. Before a child undergoes any surgery of this type, it is important for the parents, and the child if he or she is old enough, to understand the expected residual handicap due to the hemiparesis.…”

Section: Indications and Selection Criteriamentioning

confidence: 99%

“…Again, Rasmussen and Sturge-Weber syndromes and vascular insults had a better prognosis (94.6% of patients became seizure free) than did multilobar cerebral dysplasia and other etiologies (68% seizure free). 9,10,18,21,22,34,36,55,60,65 When comparing different techniques, the seizure outcome seems to be constant. Another case series comparing anatomical hemispherectomy, functional hemispherectomy, and hemispherotomy 12 showed no significant differences between the 3 groups, with 71% of patients overall…”

Section: Surgical Outcomementioning

confidence: 99%

Hemispherotomy and other disconnective techniques

Ribaupierre

Delalande

2008

FOC

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The surgical treatment of intractable epilepsy has evolved as new technical innovations have been made. Hemispherotomy techniques have been developed to replace hemispherectomy in order to reduce the complication rates while maintaining good seizure control. Disconnective procedures are based on the interruption of the epileptic network rather than the removal of the epileptogenic zone. They can be applied to hemispheric pathologies, leading to hemispherotomy, but they can also be applied to posterior quadrant epilepsies, or hypothalamic hamartomas. In this paper, the authors review the literature, present an overview of the historical background, and discuss the different techniques along with their outcomes and complications.

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Cerebral hemispherectomy

Cited by 288 publications

References 44 publications

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Literacy after cerebral hemispherectomy: Can the isolated right hemisphere read?

Hemispherotomy and other disconnective techniques

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